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Association between weekend admission and mortality for upper gastrointestinal hemorrhage: an observational study and meta-analysis

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Abstract

Higher in-hospital mortality for weekend vs. weekday admissions has been described. We performed a retrospective study and accompanying meta-analysis to examine the association between weekend admission for upper gastrointestinal hemorrhage (UGIH) and in-hospital mortality. We identified adult admissions to United States (US) hospitals for acute variceal and nonvariceal UGIH between 1/2010 and 12/2012 from the National Inpatient Sample (NIS). We used multivariable logistic regression to compare the odds of in-hospital mortality (adjusting for hospital- and patient-level factors) for weekend vs. weekday admissions. For our meta-analysis, we searched MEDLINE and SCOPUS to identify NIS studies. Using cumulative meta-analysis, we calculated the adjusted odds ratio (aOR) of in-hospital mortality for variceal and nonvariceal UGIH weekend admission. From 2010 to 2012, we identified 119,353 admissions for UGIH. After multivariable adjustment, there was no difference in the odds of mortality for weekend admissions with variceal (aOR 1.00; 95 % CI 0.81–1.23) or nonvariceal UGIH (aOR 1.10; 95 % CI 0.99–1.22); although, a decreased use of endoscopy in weekend admissions for all-cause UGIH (adjusted hazard ratio 0.91; 95 % CI 0.89–0.92) was observed. Meta-analysis of five studies (including our own) shows no association between weekend admission and mortality for variceal UGIH (aOR 1.02; 95 % CI 0.86–1.21). Weekend admission for nonvariceal UGIH is associated with an increased odds of mortality (aOR 1.09; 95 % CI 1.04–1.15). Weekend admission for UGIH is not associated with a higher odds of in-hospital mortality in our observational study. However, we observed a 9.0 % increase in nonvariceal UGIH mortality for weekend admissions in our meta-analysis.

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Authors and Affiliations

  1. University of Connecticut School of Pharmacy, 69 N. Eagleville Rd, Unit 3092, Storrs, CT, 06269, USA

    Erin Renae Weeda, Brandon Scott Nicoll, Craig Ian Coleman & William Leslie Baker

  2. Griffin Hospital, Derby, CT, USA

    Anna Sharovetskaya

Authors
  1. Erin Renae Weeda
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  2. Brandon Scott Nicoll
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  3. Craig Ian Coleman
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  4. Anna Sharovetskaya
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  5. William Leslie Baker
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Correspondence to William Leslie Baker.

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Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. It should also be noted that all data were de-identified; thus, our study was exempted from institutional review board oversight. This article does not contain any studies with animals performed by any of the authors.

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Weeda, E.R., Nicoll, B.S., Coleman, C.I. et al. Association between weekend admission and mortality for upper gastrointestinal hemorrhage: an observational study and meta-analysis. Intern Emerg Med 12, 163–169 (2017). https://doi.org/10.1007/s11739-016-1522-7

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  • DOI: https://doi.org/10.1007/s11739-016-1522-7

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